The Justice Department on Wednesday announced 53 medical professionals and seven other individuals have been charged in connection with allegedly illegally prescribing and distributing opioids and other dangerous narcotics.

The charges involve more than 350,000 prescriptions written for opioids and other controlled substances—totaling more than 32 million pills—in Ohio, Kentucky, Tennessee, Alabama and West Virginia.

The charges resulted from the Justice Department’s Appalachian Regional Prescription Opioid Strike Force, which included 14 health care fraud prosecutors. Some cases involved people who wrote up to 100 prescriptions per day, or who wrote prescriptions with no evidence the patient had been physically examined.

Heroin & the Opioid Epidemic: From Understanding to Action

Heroin and other opioids are ravaging communities across America. Heroin-related deaths increased by more than five times between 2010 and 2017, and drug deaths from fentanyl and other synthetic opioids are seeing a sharp rise as well.